Phenotype variability of the dominant beta-thalassemia induced in four Dutch families by the rare cd121 (G-->T) mutation

BACKGROUND: Initial clinical experience with recombinant factor VIIa (rVIIa) for treatment of haemophilia patients with inhibitors against factor VIII or IX has been obtained by administration of rVIIa by repeated intravenous bolus injections. However, continuous infusion of rVIIa may be a more appropriate administration method if prolonged treatment is indicated. METHODS: We have surveyed and analysed the initial experience with continuous infusion of rVIIa in the Netherlands and Belgium. RESULTS: Five hospitals treated 7 haemophilia patients with inhibitors on 9 different occasions (4 bleedings, 5 surgical interventions) by continuous infusion of rVIIa over a total of 59 days. Haemostatic coverage was considered effective in 8 out of 9 cases and partially effective in 1 case. Continuous infusion of rVIIa was aimed at rVIIa target plasma levels of 10 U/ml and a decrease in prothrombin time (PT) of 3 s compared to control levels. This was obtained by an initial bolus injection of 90 micrograms/kg prior to continuous infusion of rVIIa at doses between 30-6 micrograms/kg/h (mean 17.5 micrograms/kg/h). A conventional one-stage factor VII coagulation assay, often used in combination with a PT, was satisfactory in monitoring rVIIa treatment. The additional clinical value of anti-fibrinolytic and anti-thrombophlebitic treatment was unclear. CONCLUSION: In our experience, rVIIa appeared to be efficacious and safe when administered by continuous infusion. Continuous infusion of rVIIa is more convenient than bolus injections or rVIIa, easy to monitor and provides a cost reduction of > 50%. These advantages make continuous infusion an attractive administration method for prolonged treatment with rVIIa.     

Spectra of spontaneous frameshift mutations at the hisD3052 allele of Salmonella typhimurium in four DNA repair backgrounds

In the model of Baddeley (Working Memory, Oxford University Press, Oxford, 1986), one function of the visuospatial sketchpad (VSSP) component of working memory is to allow the processing of mental images. Properties of the VSSP were investigated by means of the usual dual-task paradigm (to search for interference from the other components of working memory, i.e., the articulatory loop and the central executive), applied to three distinct subprocesses of mental imagery (Kosslyn, 1994 Image and Brain. MIT Press, Cambridge, MA): image generation (Experiment 1), image maintenance (Experiment 2), and image rotation (Experiment 3). First, in the control condition (no interference task) of each experiment, we replicated the effects of stimulus or task complexity already reported. Second, no interference from the articulatory loop was observed. Third, maintenance of images appeared free from any interference. And fourth, generation and rotation tasks were interfered to a greater extent by the central executive than by the involvement of the VSSP in a secondary task. These observations (a) support the dissociation between the articulatory loop and the VSSP, (b) suggest an important use of central attentional resources in the generation and rotation of mental images, (c) would support the distinction between visual and spatial components in the structure of working memory, and (d) suggest the dissociation of the VSSP into two subcomponents: a passive visuospatial store and an active device for recapitulating visuospatial information.     

Mutagenicity and mutation spectra of 2-acetylaminofluorene at frameshift and base-substitution alleles in four DNA repair backgrounds of Salmonella

Neurons in the superior vagal (jugular) ganglion relay afferent information from thoracic visceral organs and may be important in inflammatory processes due to the peripheral release of bioactive neuropeptides such as substance P. We characterized the excitable properties and underlying voltage-gated Na+ (INa) and K+ (IKv) currents in acutely dissociated guinea pig jugular ganglion neurons with microelectrode and whole-cell patch-clamp recording techniques. Current clamp recordings revealed a resting potential of approx. -55 mV and input resistance of approx. 100 M ohms. Brief depolarizing steps evoked an overshooting action potential (approx. 2 ms duration), fast (< 20 ms duration) afterhyperpolarization (AHPF) sequence in all neurons, followed by a slow (> 1 s) Cd(2+)-sensitive afterhyperpolarization (AHPS) in 45% of the neurons. The AHPS was implicated in limiting repetitive action potential firing during maintained depolarizing steps. The action potential in 15/17 neurons, and a major component of the whole cell INa in 13/13 neurons were insensitive to TTX (1-10 microM), indicating that jugular neurons express predominantly a TTX-resistant type of INa. Cd2+ (200 microM) did not affect action potential repolarization, while tetraethylammonium (TEA; 10 mM) in the presence of Cd2+ markedly prolonged action potential repolarization, and blocked the AHPF in 11/11 neurons. This suggested that the action potential repolarization and the AHPF are mediated by IKv, with little contribution by Ca(2+)-dependent IK (IK(Ca)). Whole cell IKv activated rapidly (tau < 1.5 ms), and inactivated variably over a time period of seconds. IKv activation and inactivation voltage dependencies and TEA sensitivity were compatible with its availability during the action potential and AHPF. Only 1/26 neurons exhibited current with the rapid inactivation kinetics and voltage-dependencies characteristic of classic IA-type current. These results highlight differences in the properties of jugular neurons (e.g., deficiency of rapid IA, and lack of a TTX-sensitive subpopulation), relative to those known for other visceral and somatic afferents, and thus provide a basis for further functional studies.     

Two-nucleotide codon change in a hemoglobin polymorphism of the Celebes black ape (Macaca nigra)

A hemoglobin polymorphism involving variant beta-chains was demonstrated in the Celebes black ape, Macaca nigra. Fingerprinting and amino acid analysis of the tryptic peptides from the two chain types have shown that they differ by a single amino acid substitution, between lysine and aspartic acid, which requires a two-nucleotide change in the corresponding codon. Another substitution in the same codon is found as a species between the black ape and that of other macaques.     

Delayed clearance of ICG observed in the course of hepatitis (posthepatitic ICG excretory defect) (author''s transl)

Pulmonary blood flow distribution was studied by scintillation scanning of the lungs after the infusion of iodine- 131-labeled macroaggregates of human albumin before and after the Mustard operation in 53 patients with transposition of the great arteries. The patients were classified as follows: Group I (24 infants with uncomplicated transposition of the great arteries); Group II (18 patients with transposition and ventricular septal defect); and Group III (11 patients with transposition, ventricular septal defect and pulmonary obstruction). Before operation, 21 patients had a normal distribution of pulmonary blood flow, 10 had preferential flow to the right lung and 2 had preferential flow to the left lung. After operation, 19 had a normal pattern of pulmonary blood flow, 21 had preferential flow to the right lung and 3 had preferential flow to the left lung. The scanning studies have proved helpful in follow-up of patients to rule out recurrence of the shunt, pulmonary of systemic venous obstruction, development of pulmonary hypertension and occlusion of a palliative systemic-pulmonary shunt.     

Frameshift mutation at codon 642 of the hMLH1 gene in human endometrial cancer

One hundred and fifty ASA 1 and 2 patients were randomly allocated to receive pethidine 25 mg (1 ml), lignocaine 10 mg (1 ml) or 0.9% saline (1 ml) on a double-blind basis, as pretreatment to reduce pain on injection of propofol. Both active treatments were significantly better than placebo at preventing pain (p < 0.01). Lignocaine was most effective in preventing pain in men (p < 0.05) whilst pethidine was more effective in women (p < 0.05).     

Alloimmunization against human platelet antigen 2 (HPA2) in a series of multi-transfused beta-thalassemia patients

In our study we investigated the presence of anti-human platelet antigen (HPA) alloantibodies in a series of 10 beta-thalassemia major patients submitted for more than 10 years to periodic blood transfusions (every 2-3 weeks). We found that 2 out of the 10 patients developed anti-HPA2a + HPA1b and anti-HPA2b antibodies. Our results highlight that HPA alloimmunization in multitransfused patients is a real possibility.     

Hypertrophic obstructive cardiomyopathy due to a novel T-to-A transition at codon 624 in the beta-myosin heavy chain (beta-MHC) gene possibly related to the sudden death

The protective role of vitamin E (vit E) on lead-induced thyroid dysfunction with special reference to type-I iodothyronine 5'-monodeiodinase (5'D-I) activity in mice liver was investigated. Daily intraperitoneal (i.p.) injection of lead acetate (0.5 mg/kg body weight) for 30 days significantly decreased serum 3,3',5-triiodothyronine (T3) concentration and hepatic 5'D-I activity. Furthermore, lead significantly increased peroxidative reactions involving membrane components (lipid peroxidation, LPO) while the activities of antioxidant enzymes such as superoxide dismutase (SOD) and catalase (CAT) were decreased in mouse liver. Simultaneous administration of vit E (5 mg/kg body weight) and 0.5 mg/kg body weight of lead restored thyroid function in mice by maintaining normal hepatic 5'D-I activity and serum thyroid hormone concentrations. It also prevented increase in LPO and inhibition of SOD and CAT activities in liver. We suggest that the intact membrane structure is a must for 5'D-I activity and the administration of vit E may prevent the lead induced thyroid dysfunction by maintaining membrane architecture.     

Detection of human herpesvirus 8 (HHV 8) in Kaposi sarcomas of the gastrointestinal tract

Involvement of Kaposi's sarcoma in the gastrointestinal tract is common in AIDS patients. The disease is, however, usually asymptomatic and, due to the tumor growth primarily in the submucosa, biopsy diagnosis is possible in under 25%. The recently described human herpes virus 8 (HHV8) is closely associated with all forms of Kaposi's sarcoma. Detection of HHV8 in the tissue samples may therefore improve the diagnosis of gastrointestinal Kaposi's sarcoma. In the present study we analyze autopsy samples of tumor and non-tumor tissue from the gastrointestinal tract in patients with and without Kaposi's sarcoma for the presence of HHV8 DNA using a nested polymerase chain reaction (PCR) assay. HHV8 DNA was present in all 15 tissues with Kaposi's sarcoma. In contrast, HHV8 DNA was present only in 3 (18.8%) of 16 gastrointestinal tissues of patients with Kaposi's sarcoma but without histologically detectable tumor. No HHV8 DNA was present in 15 tissue samples of AIDS patients without Kaposi's sarcoma. Our data show that detection of HHV8 DNA using a nested PCR assay is a highly sensitive and specific diagnostic test for Kaposi's sarcoma in autopsy tissue samples from the gastrointestinal tract. It should therefore be possible to use detection of HHV8 DNA in biopsy material as an assay for the diagnosis of Kaposi's sarcoma.     

Complete thyroxine-binding globulin (TBG) deficiency produced by a mutation in acceptor splice site causing frameshift and early termination of translation (TBG-Kankakee)

Fourteen T4-binding globulin (TBG) variants have been identified at the gene level. They are all located in the coding region of the gene and 6 produce complete deficiency of TBG (TBG-CD). We now describe the first mutation in a noncoding region producing TBG-CD. The proband was treated for over 20 yr with L-T4 because of fatigue associated with a low concentration of serum total T4. Fifteen family members were studied showing low total T4 inherited as an X chromosome-linked trait, and affected males had undetectable TBG in serum. Sequencing of the entire coding region and promoter of the TBG gene revealed no abnormality. However, an A to G transition was found in the acceptor splice junction of intron II that produced a new HaeIII restriction site cosegregating with the TBG-CD phenotype. Sequencing exon 1 to exon 3 of TBG complementary DNA reverse transcribed from messenger RNA of skin fibroblasts from an affected male, confirmed a shift in the ag acceptor splice site. This results in the insertion of a G in exon 2 and causes a frameshift and a premature stop at codon 195. This early termination of translation predicts a truncated TBG lacking 201 amino acids.     

Interaction of fibronectin (FN) cell binding fragments and interleukin-8 (IL-8) in regulating neutrophil chemotaxis

This study investigated the possible interaction of FN fragments in regulating IL-8-mediated neutrophil chemotaxis in vitro using Neuroprobe microchambers. Human neutrophil suspensions were incubated with purified FN fragments or an RGD-containing peptide and allowed to migrate in response to chemotactically active concentrations of human recombinant IL-8. The 120-kD fragment of FN containing the RGD sequence or an RGD peptide (GRGDSP) inhibited IL-8-mediated neutrophil chemotaxis; however, these RGD peptides did not inhibit neutrophil chemotaxis in response to other chemotactic agents. Furthermore, FN fragments not containing the RGD sequence had no effect on IL-8-mediated chemotaxis. These data suggest that directed migration of neutrophils in response to IL-8 is inhibited in the presence of cell-binding fragments of FN and may represent a local mechanism for terminating neutrophil migration at areas of tissue injury.